Infection prevention and control is a simple process that should be a continuous and on-going part of your program.
Keep children healthy by ensuring timely communication and cooperation among staff, parent(s) / caregiver(s), health care providers and Public Health.
Every licensee shall ensure that a daily observation is made of each child receiving child care in each child care centre it operates and in each premises where it oversees the provision of home child care before the child begins to associate with other children in order to detect possible symptoms of ill health.
- Child Care and Early Years Act, 2014, S.O. 2014, c. 11, Sched. 1 Section 36. (1)
Call Public Health. We can come to your child care centre and provide your staff guidance and in-services on:
We can also offer your child care attendees an interactive experience on:
To learn more, call 905-688-8248 or 1-888-505-6074 ext. 7330, or email Infectious Diseases.
One exposure to germs by a child or adult can be enough to spread infection throughout your centre. Although you can't prevent all illnesses, by knowing what to do, you can control how many people are infected.
It's also important to know when to:
At drop-off and throughout the day, watch for these symptoms:
Clean your hands: The most important thing you can do is to clean your hands well and often throughout the day.
Observe the children daily: Staff should assess a child for illness every day upon arrival to the centre and throughout the day. Communicate to parent(s) / caregiver(s) the importance of keeping staff informed about any illness that the child may have or been in contact with.
Get immunized: Immunization is the most effective way of preventing vaccine preventable diseases such as influenza, COVID-19, whooping cough, measles and mumps. Keep up-to-date health records for children and staff.
Follow proper diaper changing and toileting routines: This is critical as intestinal infections in child care centres are closely related to the presence of young children in diapers.
Put policies in place: Make sure you have written policies that are regularly reviewed and communicated to staff, volunteers and parent(s) / caregiver(s). These should focus on health records, immunization, exclusion criteria, hygiene, cleaning and disinfecting, food safety and contacting Public Health.
Use routine practices: Any person can be carrying an infection and their bodily fluids could contain illness-causing germs. Being aware is especially important when you are in contact with or exposed to bodily fluids. Wash your hands well, use gloves, and clean / disinfect surfaces carefully.
Clean and disinfect surfaces regularly: This is very important as many germs that are spread from person-to-person are stable and live on surfaces for hours and days. Follow these practices consistently to protect children and staff from becoming ill.
Handle and store food safely – This prevents the growth of germs and contamination by insects or rodents
Consider if animals should be permitted: Keep in mind that children and staff may be allergic. An ill animal can be infectious to humans, and even docile pets can bite.
Cover your cough and sneeze: Use a tissue or the sleeve of your upper arm. Don't use your hands.
Young children often bite each other during play or while fighting. Parent(s) / caregiver(s) may be concerned about the possible spread of infections, such as hepatitis and HIV. Although the risk of infection is low, parental anxiety may be high.
If the skin isn't broken, clean the wound with soap and water, apply a cold compress and soothe the child who was bitten.
If the skin is broken:
Bacterial meningitis
All cases must be discussed with Public Health on an individual basis
Chickenpox
A child with mild chickenpox can continue to attend child care regardless of the state of their rash, provided they are well enough to take part comfortably in all program activities, including going outside. A child with a high fever or enough spots to be uncomfortable, or who is feeling unwell, should be kept at home until well enough to participate.
COVID-19
Children who have COVID-19 symptoms (regardless if they tested positive for COVID-19 or not) should self-isolate and not attend child care until they are fever free (without the use of fever reducing medication) and other symptoms are improving for 24 hours (or 48 hours if gastrointestinal symptoms are present, like nausea, diarrhea or vomiting).
Hepatitis A
Children with acute infection should be excluded for one week after onset of illness or jaundice (yellowing of the eyes and skin). Public Health staff will be in contact with your child care centre regarding recommendations for contacts of a case.
Influenza (flu)
Children should not attend child care or school until five days after the start of symptoms, or until fever free and can participate in activities.
Measles
Exclude for four days after the onset of rash. Public Health staff will be in contact with the child care centre to discuss exclusion of ill child to and recommendations for contacts of a case.
Mumps
Exclude for five days from the onset of swelling. Public Health staff will be in contact with the child care centre to discuss exclusion of ill child and children who are unimmunized or inadequately immunized.
Pertussis (whooping cough)
A child can return to the child care centre three weeks after intense coughing begins, or after five days of appropriate antibiotic treatment.
Rubella (German measles)
Exclude for seven days after the rash is first noticed. Public Health staff will be in contact with your school or child care centre to discuss exclusion of ill child and children who are unimmunized or inadequately immunized.
Report diseases to the Infectious Disease program at 1-888-505-6074 or 905-688-8248 ext. 7330, Monday to Friday 8:30 a.m. to 4:30 p.m. For reporting after hours, call 905-984-3690.
Common cold
Children may continue to attend the child care centre if feeling well enough to take part in regular daily activities.
Diarrhea
A child can attend the child care centre 24 hours after they no longer have symptoms of diarrhea or 48 hours if the centre is in an outbreak situation. This may vary depending on cause of illness, number of cases and source of infection.
Fever
A child must be fever-free, without the use of fever-reducing medicine, for 24 hours before returning to the child care centre. Upon return, the child must be able to participate in all activities including outdoor play.
Fifth disease
A child can attend the child care centre because they are no longer contagious once the rash appears.
Hand / foot and mouth
A child may return to the child care centre when feeling well enough to take part in activities. However, keeping young children at home who drool and have blisters in the mouth or children with a weeping rash on the hands, can help to reduce the spread of infection to others.
Impetigo
A child should not return to child care until the antibiotic prescribed by a health care provider has been taken for at least one full day (24 hours), and the child is well enough to take part in all program activities.
Molluscum Contagiosum
No exclusion necessary.
Pink eye
A child with pink eye should be kept home until seen by a health care provider. If bacterial, the child can return to the child care centre after 24 hours of appropriate antibiotic treatment. If viral, the child can return with the health care provider’s approval. No need to exclude if there's no eye discharge, unless there is an outbreak
Pinworm
Children can return to child care after treatment has started.
Ringworm
Children can return to child care after treatment has started.
Roseola
Children may continue to attend child care centre if feeling well enough to take part in regular daily activities.
Scabies
Children can return to child care after treatment has been applied.
Strep throat
A child should not return to child care until the antibiotic prescribed by a health care provider has been taken for at least one full day (24 hours), and the child is well enough to take part in all program activities.
The Medical Officer of Health, under legislated authority and with the Board of Health, is responsible for the health of the public. The medical officer provides expertise, leadership and guidance in all public health matters.
According to provincial legislation, certain diseases must be reported immediately to Public Health.
Post the diseases of Public Health significance resource in a visible location and make staff aware of its content.
Last updated: Sept. 28, 2022